The American Society for Microbiology (ASM) is pleased to see that the NIH Strategic Research Plan and Budget to Reduce and Ultimately Eliminate Health Disparities, Fiscal Years 2002 - 2006 addresses a multidisciplinary approach, as the etiologies of health disparities are clearly multifactorial. Undoubtedly, the meaningful involvement of community groups and minority organizations and increased minority participation in biomedical related careers will strengthen the capacity for reducing health disparities. The ASM is the largest educational, professional, and scientific society dedicated to the advancement of the microbiological sciences and their application for the common good. The Society represents more than 42,000 microbiologists, including scientists and science administrators working in a variety of areas, including biomedical, environmental, and clinical microbiology.

While the research infrastructure component includes providing support for research and career training for minority scientists, it does not address the importance of retaining some of these programs at undergraduate minority serving institutions. There continues to be a concern that competition from majority schools with enhanced research facilities will prevent minority schools from acquiring funds to increase their capacity for training students. Given that these schools continue to produce a large number of undergraduates who go on to pursue Ph.D.s, it is imperative that these schools receive research and training support. Also, traditionally the success of these undergraduate research programs has been measured by the number of students entering and completing doctoral level graduate programs. The ASM urges support of undergraduate students who wish to pursue degrees in medicine as they will be key in addressing health disparities and also because there is a dire need to increase the number of minority physicians. Data reveal that minority physicians are more likely to service minority populations. Additionally, students with MD degrees are highly sought for training positions as clinical researchers. Thus, it might be advantageous to look at the ability of schools to produce minority MDs as a factor in measuring program success.

Construction and renovation of research facilities should also specifically target minority serving institutions which are often located in both underserved and at risk communities.

Enhancement of these research facilities may enable those institutions to conduct health disparities research in areas of behavioral science, public health, and epidemiology.

The emphasis of objectives to increase efforts and launch campaigns that educate both the public and healthcare professionals about health disparity related issues is applauded. However, additional efforts to educate both K-12 students and teachers in at risk communities could prevent these individuals from facing health disparities and provide exposure to the importance of clinical and basic research programs.

Information about proper nutrition, obesity and its health consequences, and sexually transmitted diseases are useful resources to combating health disparities. Further, educating parents and elderly individuals about the importance of child and adult immunizations in the prevention of diseases and disabilities that contribute to health disparities as well as providing access to these immunization programs could also help to alleviate health disparities. An emphasis on educational programs to interest students often affected by health disparities should begin early and should not be limited to urban areas, but include rural areas, as well. Strengthening and providing more and earlier K-12 programs could help to heighten student awareness of both clinical and basic research careers. Additionally, efforts to include community colleges in programs of this nature should also be strengthened.

In addition to research on infectious diseases such as HIV/AIDS, Hepatitis C, and specific bacterial related diseases, the role of latent infectious agents that might trigger chronic diseases associated with health disparities such as diabetes, heart diseases, and cancer, should be included in the research objectives.

Lastly, the recent threats from anthrax exposures and the introduction of smallpox immunizations revealed that minority and low-income communities were disproportionately (negatively) impacted. It might be advantageous for the plan to address research and training on related bioterrorism issues.

Thank you for the opportunity to submit comment on the NIH’s Strategic Plan. If you have any questions, feel free to contact the Office of Public Affairs at (202) 942-9209.